Abstract
Malignancy is a well-established risk factor for venous thromboembolism and while low-molecular-weight heparin therapy has been standard of care for cancer-associated thrombosis for many years, many patients find injection therapy burdensome. The direct oral anticoagulant edoxaban has been shown to be noninferior to dalteparin for the treatment of cancer-associated thrombosis. In a Markov simulation model, edoxaban with 6-month time horizon and a United States societal perspective with 2017 US dollars, edoxaban was the preferred strategy in the general cancer population (6-month cost $6061 with 0.34 quality adjusted life years) and in a subgroup of patients with gastrointestinal malignancy (6-month cost $7227 with 0.34 quality adjusted life years). The incremental cost effectiveness ratio of dalteparin compared to edoxaban was $1,873,535 in the general oncology population and $694,058 in the gastrointestinal malignancy population.
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NTC and JMC designed the study, analyzed the data, critically evaluated and edited the manuscript, and provided final approval. NTC built the Markov model and ran the analyses.
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NT.C.: no financial conflicts of interest. J.M.C.: Honoraria or consulting fees from Bristol-Myers Squibb, Portola, Research funding to the institution CSL Behring.
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Connell, N.T., Connors, J.M. Cost-effectiveness of edoxaban versus dalteparin for the treatment of cancer-associated thrombosis. J Thromb Thrombolysis 48, 382–386 (2019). https://doi.org/10.1007/s11239-019-01903-z
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DOI: https://doi.org/10.1007/s11239-019-01903-z